From focus group discussions it may be deduced that there is low social cohesion within the KwaNcgolosi community with regards to issues related to HIV/AIDS, which is conceptualised according to Hseih (2008:152) as “the abundance of moral support, which, instead of leaving individuals to rely on their own resources, leads them to share in the collective energy and supports them when their individual resources are exhausted.” According to focus group participants, such sharing and support is currently not occurring – those who are ill are largely isolated from other community members, and in extreme cases by family members as well. Reasons for this vary, but appear largely to stem from fear and
lack of trust. Community members who do wish to provide care and support also often find themselves prevented from doing so by these same reasons – however focus group participants also spoke of many other community members who were not interested in caring for or supporting those ill with HIV/AIDS, attributing this to reasons such as destructive social norms. Additionally, focus group participants felt that any initiatives to increase social cohesion within the community may not be taken seriously, or might be met with a general lack of interest.
Considering the social assessment survey responses, in terms of both overall general social cohesion and social cohesion related to HIV/AIDS, and given focus groups‟ perceptions of low levels of social cohesion related to HIV/AIDS, it appears that social cohesion when concerned with HIV/AIDS is lower than for other community issues. When asked about the feeling of togetherness within the community, 5.8% of survey respondents felt that people were very distant, 12.4%
felt that they were somewhat distant, 16.8% felt that people were neither distant nor close. The majority (62.4%) felt that community members were close, with 38.1% saying somewhat close, and 24.3% responding very close. Additionally, when asked how many close friends they have, or people that they felt at ease with discussing private matters, 20.3% of respondents said none, 31% of respondents felt that they had one close friend, and 22.2% said two close friends.
15.1% felt that they had between 3 and 6 close friends, and less than 2% felt that they had between 6 and 10 close friends. There was one response each (0.1%) for 12, 14, 18, 22, and 30 close friends.
In terms of reliance on others for resources, 45.2% of survey respondents felt that they could not rely on anybody beyond their immediate family to borrow money, 8.3% were unsure, and 45.3% felt that they were able to. When considering whether or not community members could rely on others to take care of their child while they were away, 21.8% felt that they could not, 9% were undecided, and 68.1% felt that they could. Additionally, if help was needed, 31.2% of
respondents felt that most people in the community would not be willing to help, 17.4% were undecided, and 50.8% felt that others would assist them. However, the translation of this perceived social cohesion into collective action is very low:
When asked how often within the last 12 months community members had gotten together to jointly request something from leaders that would benefit the community, 37.6% said never, 36.8% said once, 19.4% said a few times (3 or less) 3.6% said many times (6 or less), and 0.9% said very often. It would therefore appear that although there is perceived general trust and social cohesion within this community, this is not leading to collective action. A tentative explanation for this, however, may be a lack of knowledge about how to take action, or how to speak to leaders, which points to a deficit in information sharing through networking, as well as a deficit in Social Bridging.
When considering social cohesion in relation to HIV/AIDS, it is important to note that in terms of the notion of Ubuntu as a motivating factor in joining in volunteer activities for one with HIV/AIDS, 21% of survey respondents felt that it was not important, 26.3% were unsure, and 52.4% felt that it is an influential factor.
When asked if they would join a group or organization providing HIV/AIDS services within the community, 22.8% said that they would not, 6.3% were unsure, and 70.8% said that they would join. This is consistent with the observed, current untapped potential within this community with regards to care and support for those with HIV/AIDS. It therefore appears that although there may be a willingness to participate in care and support for those with HIV/AIDS, there is currently no space in which to do so. However, it is interesting to note that focus group participants felt that there would be a lack of interest from community members regarding HIV/AIDS initiatives, whereas the social assessment survey indicates that this would not be the case. Two tentative explanations may be offered for this discrepancy: Firstly, the lack of social discussion and informal conveying of information regarding HIV/AIDS within this community, may have resulted in community members feeling that others are still holding persisting negative beliefs about the disease, even if they do not have the same beliefs
themselves. Therefore, although there is a current lack of social cohesion regarding HIV/AIDS within the KwaNgcolosi community, this may not be because of a lack of willingness, but is rather attributed to the current lack of trust, reciprocity, and social norms surrounding the disease, and an “othering” of perceptions, attitudes and norms surrounding HIV/AIDS. The second potential explanation is the possibility of social desirability in the survey responses. Social desirability is explained by Mick (1996) as the tendency of respondents to portray themselves in a positive light, in accordance with current social and cultural norms. As such, respondents of this survey giving socially desirable answers would then portray themselves as being willing to assist and engage in community activities.
6.2.1 Social Capital, Social Cohesion and Health
McKenzie, Whitley & Weich (2002), and Helliwell & Putnam (2004) note that the social context significantly affects individual‟s mental and physical health. It therefore becomes apparent that social cohesion within the community plays an important role in the health of an individual. As such, the emotions and perceptions of an individual who is ill with HIV/AIDS may be seen as an indicator of the perceived attitudes and situation within the community. Focus group participants noted that for those who were ill with HIV/AIDS, stress was extremely common, and in fact was perceived by many as the primary reason of death. This confirms the current lack of social cohesion noted within the KwaNgcolosi community in relation to HIV/AIDS.
The perceptions of stress as it related to HIV/AIDS were noted by the focus group of men aged 18-25, and two of the female focus groups, aged 26-45 and 46 and older. Such findings are noted by Poortinga (2006), who concluded that personal levels of social support are consistent with higher levels of self-reported health status. As such, higher levels of Bonding Social Capital result in better health, in addition to greater access to social networks, and social support.
The stress of such individuals may be attributed to two causes. Firstly, in a context where HIV/AIDS is viewed as a shameful disease and therefore linked to stigma and a lack of support – reduced levels of Social Capital - those who have the disease are likely to become stressed (Chiu et al, 2008), thus negatively affecting their health status.
Secondly, the focus group of men aged 18-25 and 26-45 spoke about the person who is ill with HIV/AIDS thinking that they are going to die, which participants also felt was a cause of stress for such people. South Africa has an extremely high HIV/AIDS burden (WHO/UNAIDS, 2008), and insufficient health resources to meet the needs created by this burden, particularly in rural areas (Lewis, 2008), such as the community of KwaNgcolosi. A perceived lack of access to formal health care and resources may also be a cause of stress. Stafford, De Silva, Stansfield & Marmot (2007) and Poortinga (2006) also noted that lower socio- economic status seems to be associated with lower health status. This is applicable to the KwaNgcolosi community, as the majority of individuals residing here would fall into this category.